双向内镜和药理方法治疗严重的右侧结肠便冲击
Raguraj Chandradevan1, Judith Handley2, Satish Rao3
1Gastroenterology/Hepatology, Medical College of Georgia, Augusta University, Augusta, Georgia, USA.
BMJ case reports
|April 30, 2025
概括
一种新的三方方法成功地治疗了患有硬化皮质症和贝赫特病的患者的严重便损伤,从而预防了切除术. 这种门诊策略结合了透性松剂和周围静脉刺激剂,以有效地减轻影响.
科学领域:
- 胃肠病学 胃肠病学
- 结肠直肠手术 结肠直肠手术
背景情况:
- 严重的便损伤可能需要切除,特别是在患有复杂并发症的患者中.
- 结核病和贝希特病在治疗胃肠道运动障碍方面存在独特的挑战.
研究的目的:
- 描述一种新的,双向的,门诊的方法来治疗严重的近端结肠便损伤.
- 为了评估一个结合的透性松剂和围静止刺激剂策略在患有耐火性体冲击和显著的并发病症的患者的疗效.
主要方法:
- 采用了双向的方法,包括通过肠镜注射酸,通过结肠镜注射右结肠胃谱,以及静脉注射neostigmine来刺激周围心电.
- 这三方面策略在门诊环境中进行了36小时的治疗.
- 这位患者患有硬化皮质和贝塞特病,出现脱水,体重减轻,发烧和严重的近端结肠便冲击,不耐常规治疗.
主要成果:
- 在36小时内取得了成功的减损效果,避免了切除术的需要.
- 患者的脱水,体重减轻和发烧在成功脱落后得到解决.
- 新型门诊治疗策略在这个复杂的病例中被证明是有效的.
结论:
- 在复杂患者中,一种新的,三方的门诊方法,结合了透性松剂和周围刺激剂,可以有效地管理严重的近接结肠便损伤.
- 这种策略在某些特定情况下提供了切除术的潜在替代方案,防止了手术干预.
- 需要进一步的研究来确定这种治疗策略的安全性和有效性.
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